Lower-level hospitals invite specialists from higher-level hospitals to come over for consultations and operations, and the families pay the specialists directly for their services. All of this cost goes into the expert's pocket and there is no invoice, which is a violation of the law if strictly pursued.

According to national regulations, the procedure for inter-hospital consultations should be as follows: the head of the department submits an application to the medical department, which is responsible for contacting the higher-level hospital, and the medical department of the higher-level hospital assigns a specialist to come and assist. The fee is also regulated by the state, about 200 RMB, which is collected by the patient's hospital and forwarded to the higher hospital, and the specialist may get part of the commission according to the rules of his/her own hospital. As you can imagine, if you follow this "formal" procedure to ask for a specialist's consultation, it will take a long time, not to mention that it is almost impossible for you to see the specialist because the higher level hospital does not have the obligation to assist you.

And this current gray mode of operation is perfectly adapted to the needs of the market and in line with the interests of doctors and patients on all sides:

1 Patient:Large hospitals are expensive to treat, difficult to get a number, difficult to find a bed, far from home, and all the costs of traveling and lodging add up to a heavy burden. By doing the surgery in your own local hospital, not only are the specialists you hire more reliable than the ones you choose, but also the hospitalization fees and other additional costs you save are much higher than the labor fees you pay to the specialists, which is very cost-effective.

2 Local hospitals:Patients are retained, benefits are created for their hospitals, specialists are brought in, and skills are learned.

3 Experts:The value of the work done in one's own hospital is severely devalued. It is the "consultation fee" that really brings out the market value of a specialist's skills and allows him or her to earn an income that matches the effort he or she puts into the study of his or her specialty.

Usually the nature of the cost of such consultations is made clear by the doctor to the family in advance. Only when the family agrees will the specialist be invited over. The specialist also utilizes his own rest time, and has to take care of his own travel expenses and accommodation. A very small number of patients' families do not raise any objection beforehand, but they backtrack afterwards and seek media exposure. I think this is unethical behavior and is cutting off other patients' access to better medical resources. If they are not willing to pay, they could have refused from the very beginning.

Of course, I don't think this sort of thing is just plain right either. It is an automatic market adjustment forced out by the abnormal medical policy. If a highly skilled specialist has a good income, who would be willing to sacrifice his rest and holidays to go around and earn extra money? If hierarchical diagnosis and treatment can really be implemented, how can large hospitals be overcrowded, crowded every day, and it is difficult to find a bed? If skilled doctors, regardless of the size of the hospital, can earn a high income that matches their skills, even in small and remote places, why would they worry about not being able to hire good doctors?

I also hope that these anomalies will be wiped out one day sooner, and that doctors will straighten up their backs, take their legitimate incomes squarely, and no longer have to take the blame for the irrational system.

From the point of view of the patient's family, you should feel lucky to be able to pay for a specialist now. In the future, if controls get stricter and stricter, it's not certain what will happen.

I wonder what you think now?

Welcome to Dr. Cheng's 100 High.

When it comes to specialist fees, doctors know best. Some specialists are requested by the patient's family, so it's only natural that you should pay for the specialists' fees. Many people do not understand is that I have been hospitalized, and paid for the operation, how to pay the expert fee? This starts with the patient's surgery. Most of the experts are more complex surgical diseases, in the county hospital to do with the risk of having to ask the experts to do, some people say, since the county hospitals can not do why the patient is not to provincial hospitals to do, which in turn involves the hospitalization costs, rectal cancer, for example, the total cost of hospitals in the county hospitals 10,000 to the provincial hospitals to the total cost of 50,000 to the provincial hospitals to the provincial hospitals to reimbursement of the threshold is high, the reimbursement ratio is low, the out-of-pocket expenses part The reimbursement threshold of provincial hospitals is high, the reimbursement ratio is low, and the out-of-pocket part is 20,000, and the out-of-pocket part is 4,000 after reimbursement in the county, that is to say, it costs 16,000 more to do the same operation in the provincial hospitals, and it costs 3,000 to ask the provincial experts in the county, and the patient enjoys the treatment of the provincial experts, and the patient saves 13,000 yuan.

Don't think so poorly of doctors, the vast majority of them are looking out for their patients, even if it costs them money.

When you pay for a medical specialist to perform a surgery, it's good that they can come, and if you can't even spare that much money, then it's better not to have the treatment.

Hiring specialists is the best way to address the imbalance of healthcare in China, and the cost of doing so is much more convenient than patients and their families going to other hospitals for treatment. Hiring specialists and spending extra money, I think this is reasonable and I support it.

Nowadays, many things in China, not afraid of no good things, afraid of no good people, like this matter, so dealt with, the end result is that no doctor will do so in the future, and in the end, who is unlucky? The patients who are really in need are the people.

Some time ago, Shanxi Hongdong County People's Hospital, a doctor operating room to receive red envelopes attracted attention. Patient Han responded that she suffered from brain infarction to medical treatment, she agreed to ask the Beijing experts to do surgery, 10,000 yuan is to the expert's labor costs. At present, the doctor who helped collect the money forwarded has been suspended. Doing so, the end result is to harm others and themselves. It is a detrimental behavior.

At present, many local and municipal hospitals invite experts from famous hospitals in the north, Shanghai, Guangzhou or provincial capital cities to perform surgeries or consultations for patients in their hospitals, which is already an open practice. Some of this situation is the patient or family members to take the initiative to request; there are also by the attending physician suggested that the patient and his family agreed to invite. This phenomenon is mainly due to the current stage of China's medical resources and the level of protection at all levels of urban and regional imbalance, different levels of medical institutions in the human resources and medical technology, equipment conditions and other comprehensive medical service level there are large differences caused by. I am afraid that this situation will be difficult to change for a long time. Under these circumstances, it has come about that specialists from large hospitals are invited to small and medium-sized cities or county hospitals to provide surgical or consultative services to patients.

In accordance with the requirements of the previous regulations of the competent health authorities, the lower hospitals invite the higher hospital experts to operate and consult with the application, approval, dispatch and cost norms. The procedure is complicated, time-consuming and laborious, and the fee is very low, which is indeed difficult to match with the current actual situation. At present, the lower hospitals are mostly at the request of patients and their families, through a variety of channels to directly contact familiar with the higher hospital experts to hospital surgery or consultation, convenient and quick, timely to meet the urgent medical needs of patients, but also conducive to teaching and training of medical personnel at this level of hospitals, in fact, it is a sensible and non-compliant practice. As for the cost paid by the patient, are generally "with the market", including labor, transportation, food, accommodation and hospitality costs, with the consent of the patient and his family and recognized standards, there is a public price range, fully paid to the invited experts. Most of this cost is much lower than the total cost of patients to go to the big city hospitals, medical, transportation, food and lodging, etc., the most critical thing is to be able to save a lot of trouble, directly to the famous doctor for treatment. For patients and their families is a very cost-effective initiative. However, this phenomenon is really non-compliant, easy to cause misunderstanding, misuse, and even tax evasion and other illegal acts. Call on the relevant authorities to develop as soon as possible in line with the actual situation, convenient and efficient, conducive to the operation of the upper and lower levels of the medical institutions operating rules and procedures, conducive to the current stage of the grass-roots level of patients to obtain better protection of medical resources, so that this decades of non-compliance with the law to effectively regulate the behavior and legalization.

Questions on the cost of bringing in experts

Hiring an expert is actually hiring a flyer.

Do you think a specialist might operate on you for free?

Definitely not possible, and since it is not possible, who do you think pays for the specialist's labor and travel expenses? It is impossible for the hospital in which he lives, and even more impossible for him to be the chief surgeon.

The patient will have to pay for it.

As far as how much it costs, every place is different and every fly cutter is different. Specialist fees are a huge

Plus there's other money. Specialists come over often on weekends and

A surgery isn't just done by a surgeon. It also requires an anesthesiologist, a visiting nurse, an instrument nurse, and an assistant. These people can all work overtime to get here.

Who pays for overtime? Hospitals don't require you to work overtime, and no one wants to work overtime for less overtime pay, and you can't be forced to work overtime.

The cost must be all out of the patient's pocket.

As for why the experts were invited?

It's just a doctor's recommendation or a patient's family request.

The doctor's advice was motivated by the fact that this type of surgery could not be done well in the hospitals in the region.

The patient's request may be due to the fact that he/she is not comfortable with the standard of the local hospital or cannot go to the hospital where the specialist is located for the surgery due to restricted conditions.

In short, since you have chosen to invite a specialist to come over for surgery, the price must have been agreed upon, and you should be generous in inviting them, but you should not invite them if you are concerned or do not have that condition.

In fact, to be honest, the cost of having a specialist operate is much cheaper than what you would pay if you went to a specialist and said you would operate in a hospital.

When you ask a doctor from a higher hospital to perform an operation, the first thing you need to do is to get the consent of the family, and if the family doesn't agree, you can be referred to a higher hospital for treatment. Without this experience of the patient's family can not appreciate the difficulties and costs of visiting a higher hospital, if a highly skilled doctor of a higher hospital to travel 700 miles, or even thousands of kilometers, to be able to give you a surgery, they pay the hard work, and even the risk of what you pay you compared to what is really insignificant, on the other hand, if your disease is treated by the surgery, cured disease, what is the money ah! ? I know it's not easy for a farmer to earn money in a year, but it's not easy to be a good doctor, a highly skilled doctor, either, and the income of the people in the cities of our country greatly exceeds the yearly income of the average person in the countryside. On the other hand, the chances of getting a serious illness in one's life are not very good, and in case of all such illnesses, do you think life is important or that money is important? I think we have learned that most of the people will think that life is important. So spending some money and hiring a highly skilled doctor who customizes is a smart choice.

Surgical fees are the costs incurred by your local hospital for surgical equipment, consumables used in the surgery, the venue, and the resources of the doctor who traveled to the location. Specialist fees are the costs incurred by a specialist from a higher level hospital who travels by plane to perform the surgery on you, the two are not contradictory.

Then, I would like to ask, are you willing to pay thousands of dollars more to have a specialist from Peking Union Medical College, Huaxi or Tiantai to operate on you? Or are you willing to take a train or airplane, go to those higher hospitals to queue up, register, wait for a bed, rent a room outside to accompany you, and then I don't know how long to wait until you register, and then I don't know how long to wait for a bed, and then I don't know how long to get you scheduled for surgery? This process you rent a room in the field, food expenses have to be a few thousand it, people are also tired enough. Why do you think you are losing money when there is such a convenient and fast channel for you to enjoy the surgical treatment by experts and professors in your local area? What do you think, can you share your journey, because similar things really do not understand, a big professor, postdoctoral, doctoral supervisor to give you a personal gatekeeper surgery, safer, more secure and more at ease. Other people have learned most of their lives, practiced most of their lives in the hands of kung fu, is not worth the money? Less money, you have the skills, you are willing to toss over to the knife?

This is not a red packet, the so-called red packet in your language context refers to money used for bribery, but the money you are giving is because of the specialist fees given to foreign specialists hired because of supply and demand to come to your local hospital to do surgeries that the local doctors can't do successfully. This is a very common way for top doctors with skills to use their spare time off to make money with their skills, and rightfully so, and for patients and families who need to hire highly skilled senior doctors locally to come to their home hospitals to perform surgeries, and enjoy doing so. In fact, you can ask your village moncler outlet store and family members, they are satisfied, it is likely to the big hospital scheduled surgery is not necessarily soon to do, and a lot of hospitalization and surgical costs can not be reimbursed, inside and outside the calculation is also more than you in the home hospital to hire a specialist surgery costs, at least the family members have to rent a house to live for a while in the location of a large hospital, must not be at home to do the surgery to the convenience and The family will have to rent a house and live in the location of the hospital for a while.

Is it common to have an outside specialist surgery like this?

It can be said that where there is demand, there is a market. The distribution of medical resources in our country is very uneven, many large hospitals have a lot of high technical level, can carry out difficult surgery senior doctors, but these large hospitals are often in some big cities or central areas. The current medical structure if the family needs to do difficult surgery, can only go to the big city of the big hospitals to find a big expert to see the surgery, but if it happens to be that the hospital you visit and the higher level of cooperation with the hospital has a link, or you visit the department and some specialists have a link, will ask if you need to help to ask the experts to come to the local hospital surgery, because the technology possessed by the experts is a personal wealth, of course, to hire the experts need to pay expert Fees.

Generally such inquiries are well-intentioned, the family can get their own expectations from the technology to treat, where the hospital and the doctor is only playing a leading role, and there are experts to hospital surgery is also not lost as a valuable opportunity to observe and learn, high technology is all the doctors are expected. Of course, whether or not to hire experts must be the patients and their families to decide.

Is the specialist's fee paid by the family reasonable?

Currently there is really no regulation in this regard, but I think the cost of hiring a specialist is still reasonable, after all, the country's top experts in each field are just a few, people are so powerful of course worth that price. And the subject said that the cost of locally hired experts is a few thousand dollars, I think it's really not much, may not be the top of the expert cost, if it is the industry's top experts in a surgery how to 1w-1.5w it may also depend on the accumulation of a few cases of surgery and the difficulty of the surgery to decide whether to operate.

Isn't the cost of such a procedure worth much more than the cost of some psychological counseling that costs thousands of dollars on the market nowadays? The so-called psychological counseling is exaggerated as if it can cure all diseases. Anyone can be certified, anyone can be seen, can cure depression, can cure bipolar disorder. A few days ago, one of my fans wrote to me privately that he asked a very popular headline "expert", the expert's assistant said that the cost of each consultation 8000, about twenty times to cure bipolar disorder. But in fact? Is there a cure? The Mental Health Law has stipulated that psychological counseling shall not be used for the diagnosis and treatment of mental illness, or suspected mental illness, because it is not a medical act. Contrast this 8000 talk once the experts, the country's real top doctors, standing in the country's 360w practicing physicians the top experts once far away from the surgery, is not as good as talking to a liar once? Where is the respect for real knowledge?

The doctor-patient relationship is very tense, and we are all like living in a frigid sandwich. There are always people who put such a big hat on the heads of doctors, and one day, when all the doctors go down, who will be benefited? Respect for doctors and how far away is it?

Doctors performing "fly-by-night" surgeries are likely to become less and less common for fear of running into family members who are not of good character.

It turns out that inviting high-level experts and professors to lower-level hospitals to do surgery, and then the patient to give the professor additional consultation fees, has been a kind of "unspoken rules".

This is a win-win-win situation. The imbalance in the distribution of medical resources has led to the concentration of talents in big cities, and the development of medical standards in small cities is limited. Even if you buy equipment, no one will use it. That's why it's difficult to raise the level of medical care.

The hospital invited specialists and professors to perform surgeries, and our doctors and nurses cooperated in the surgeries, learning new procedures and developing skills.

Local patients, because they do not have to go to the big city to go to surgery, travel expenses, accommodation and food costs, treatment costs increased substantially, and very inconvenient, even if the family to visit, often have to go a long way. But if you can operate in a hospital near your home, and the surgeon is an expert from the big city, the surgical effect is better guaranteed and saves a lot of money.

I personally don't think it's too much to ask that a specialist spend time, effort, and spend their weekends off earning some extra income.

If, according to state regulations, the consultation fee for inviting experts from outside hospitals for consultation cannot exceed 500, just imagine, if it is you, letting you spend a day, catching a bus and a plane, going to do surgery on someone else, the air ticket ticket has far exceeded the amount of 500, which expert is willing to do this?

If the family is not willing to pay for this expense, who will pay for it? Moreover, before the operation, the hospital has fully communicated with the family, which is a tacit understanding. In fact, this part of the cost contributed by the family, if carefully calculated, is far less than these several thousand dollars.

There are also some patients that are not suitable for transfer, because the condition is more serious, transferring to the hospital may be dangerous on the way, can get a specialist to come and treat them in situ, at this time it is possible to save a life, please do not backtrack after the specialist has done the operation to save a life, this will make people cold.

If there is no communication with the family and a specialist is called in for the operation and the family is asked to pay for this part of the cost, this is of course not acceptable, but I believe that no doctor in any hospital will do so.

Now some patients' families, who have hired specialists, had surgery, got convenience, got benefits, although they gave money, and secretly photographed as evidence, and then sued the hospital, sued the doctor. This in itself is a problem of character.

In the future, there will be more such things, the specialists will not dare to go out for surgeries, the medical standard of the lower hospitals will not be improved, and the people will be the ones to suffer.

But that's how many people are. When they get sick, they want a local doctor to treat them, or they can get a specialist to come in for a surgery and a consultation. Once they are out of pocket, they feel they have lost out.

The selfish behavior of a small group of people can harm the people of an entire city.

First of all, it is a very good initiative to invite renowned experts from overseas to perform difficult surgeries on local patients in local hospitals. There are mainly the following reasons why this initiative is very good.

1. The distribution of medical resources in China is very uneven, with high-quality medical resources concentrated in large cities and provincial capitals. In particular, doctors who treat difficult and rare diseases are mainly concentrated in a few hospitals in the north, upstream and downstream, and the number of doctors is very small. For example, the vagus nerve stimulation surgery for intractable epilepsy, there are very few doctors who can do this surgery in China. County and city hospitals simply do not have such medical talents.

If a patient has to go to Beijing, Shanghai or Guangzhou to find a doctor who can cure him, then his relatives have to take him on a plane or train to run to the hospitals in the north, queue up, book a bed, wait to be admitted to the hospital, eat in restaurants and stay in hotels 。。。。。。 This cost is unknown how many thousands of dollars, and it is extremely inconvenient to be thousands of miles away from home.

And bringing a specialist to your local hospital can save a big chunk of the above overhead and be convenient.

In particular, some seriously ill patients, even those who are paralyzed or in a coma, do not need to be pulled by an ambulance to run up north.

2. Foreign specialists coming to perform surgeries locally can improve the standard of local hospital doctors.

When a foreign doctor comes to operate, he or she is often alone, and the local hospital has to send its own doctors as assistants and its own anesthesia team to cooperate. Through the help of experts, local hospitals can improve their surgical level and train their own medical talents.

3. It also fully mobilizes experts and maximizes their role.

Specialists usually use their rest time on weekends to travel around the world to perform surgeries, which on the one hand improves their income and provides services to more patients. To a certain extent, it makes up for the problem of uneven distribution of medical resources in China.

So this is a good initiative.

Secondly, this is not called a red envelope, this is called a labor fee. Of course, you use a red envelope wrapped to the expert for good luck, it is possible. The expert to collect the labor fee is reasonable and legitimate, and is not illegal and unlawful.

Of course, you have every right to refuse to invite an out-of-town doctor to your surgery.

I hope to look at things rationally, there is no such thing as a free lunch. Don't hold others to a level of morality that you can't even reach.